Lesotho Decentralization experience by Lebohang Mothae, CHALe
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The document discusses decentralization and devolution of healthcare in Lesotho. It provides background on Lesotho and describes the 3 levels of government - central, district, and local. Under decentralization, governance and management functions were decentralized to facilities while adhering to standardized systems, structures, and typology of facilities. This included hospital boards and health center committees governing facilities. Challenges included limited resources and capacity while successes were increased access, utilization, and community participation in healthcare.
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Investing in Africa’s health response by Rosemary Mburu, World AIDS Campaign ...
This document discusses the Global Fund's efforts to increase domestic financing for health in countries. It works with countries and partners to leverage GF resources to encourage greater government commitment to health programs, improve health data quality and accessibility, identify inefficient budgeting practices, and foster effective dialogue between health and finance officials. The GF also aims to nurture political leadership, revisit economic arguments for health, and support countries in establishing financing benchmarks. Key challenges include improving health program efficiency and effectiveness, developing advocacy for increased public health funding, and ensuring sustainability as external resources remain necessary in the short to medium term. The document outlines potential innovative domestic financing mechanisms and closes by addressing improving civil society's role and defining the optimal domestic-international investment mix country by country
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Healthy Heart Africa is a new 10-year program launched by AstraZeneca to address the growing problem of hypertension in Africa. The program aims to reach 10 million hypertensive patients across Africa by 2025 by forming partnerships with faith-based organizations (FBOs) and implementing a holistic approach. This includes increasing education and awareness of hypertension risks, promoting routine screening, improving access to affordable treatment, and establishing sustainable public health partnerships to ensure the program's long-term impact. By leveraging FBOs' existing networks and experience in local communities, Healthy Heart Africa seeks to motivate more hypertensive patients like Kioko to seek diagnosis and proper treatment.
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This document provides information about the 7th Biennial Conference of the Africa Christian Health Associations' Platform (ACHAP) being held from February 23-26, 2015 in Nairobi, Kenya. The conference theme is "The role of the faith based health services in contributing to universal health coverage in Africa." It will bring together 31 Christian Health Associations and other Church Health Networks from 26 African countries to strengthen knowledge on universal health coverage, share country experiences in health reforms, discuss approaches for sustainable health financing, and adopt ACHAP's five-year strategic plan. The expected outputs include improved understanding of universal health coverage opportunities for faith-based organizations and a joint statement of commitment on advocacy.
Progress towards universal health coverage in Ethiopia, Dr Girma Borishie, EECMY
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Uganda experience by Dr Patrick Kerchan, UPMB
The document summarizes three family planning projects implemented by the Uganda Protestant Medical Bureau (UPMB) and the involvement of religious leaders. It discusses:
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The role of performance based incentives by Dr Bill Clemmer, IMA World Health
This document discusses evolving health strategies and performance-based incentives in South Sudan. It outlines a model where one donor funds each state's health system, one organization manages the funds per state, and one NGO leads each county. Facilities and county health departments receive monthly block grants based on performance indicators like vaccines delivered and patients seen. An evaluation found a positive correlation between incentives and some indicators like antenatal care visits. The model aims to link payment to performance and skills as a sustainable way to acknowledge health workers' work and support universal health coverage in the long run.
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Health Records International by Mark Lancaster, USA
This document discusses the potential for technology like electronic health records and mobile phones to improve healthcare access and outcomes in developing areas. It summarizes the work of E-Health Records International to create affordable, easy-to-use electronic health record systems for facilities in places like Africa and Asia. Their cloud-based systems are designed to reduce costs, prevent medical errors, improve transparency and efficiency, and save lives. The presentation provides examples of how their mobile app, HarmoniMobile, structures clinical care and supports various healthcare tasks in a user-friendly interface.
Health technology and innovation for UHC by Dr Beatrice Murage, Savanna
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This document discusses evidence for effective partnerships between faith groups and the public sector to advance universal health coverage and end extreme poverty. It outlines opportunities for faith groups to strengthen partnerships by documenting health assets and outcomes, collaborating across denominations, and demonstrating impact among the poorest. The Joint Learning Initiative on Faith and Local Communities is highlighted as a platform to share evidence on immunization, resilience, gender-based violence, capacity building, and maternal and HIV health. Recommendations include improving the evidence base on faith group contributions, scaling collaboration, and making the case for faith group engagement to national plans.
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Progress towards universal health coverage in Ethiopia, Dr Girma Borishie, EECMY
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Health Records International by Mark Lancaster, USA
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The document discusses Kenya's health care system and policy. It provides information on:
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The district health system of Nepal is transitioning from a centralized system to a federal system organized around the federal, provincial, and local levels of government. This transition has led to confusion over the roles of district health offices and municipalities in managing health services and programs. Under the new system, municipalities have taken over management of many health facilities and programs from district health offices. However, the division of responsibilities between the different levels of government remains unclear, and local municipalities face challenges like limited staff and skills for managing health programs. Proper implementation of the new federal system and clear definition of roles across levels of government are needed to strengthen Nepal's health system during this transition period.
Tanzania experience by Dr Balati, CSSC
Christian Social Services Commission meeting discusses strengthening public-private partnerships and interfaith collaboration for universal health coverage in Tanzania. The CSSC coordinates over 897 church health facilities and works to improve partnerships between faith-based organizations and the government. While some successes have been achieved in areas like signing service agreements and jointly training staff, challenges remain around coordination, funding, capacity building, and utilization of human resources. Strengthening understanding of public-private partnerships at all levels and continuing to build capacity on developing and monitoring such partnerships will be important to improving health services and progressing toward universal coverage in Tanzania.
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This document provides an outline and background for longitudinal research tracking the financing of peripheral public health care facilities in Kenya. It discusses:
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Indonesia has a mixed health system with both public and private provision of care. Key achievements include increased life expectancy and reductions in communicable disease rates. However, challenges remain such as the dual burden of disease, natural disasters, weak health information systems, and high out-of-pocket expenditures. Future prospects include expanding the use of telemedicine, incentivizing an even workforce distribution, and passing more legislation to clarify the health system framework.Health services in nigeria
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Advancing an Action Plan for Community Health Centres in Rural Communities
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The document discusses partnerships between inter-faith organizations to address HIV/AIDS in Africa. It describes recommendations from a 2012 PEPFAR consultation with faith-based organizations in Africa to better leverage their roles. Partnerships between ACHAP, St. Paul's University, and Emory University's Interfaith Health Program have implemented activities in response, including mentorship for health systems strengthening, a faith and health leadership program, an interfaith center on social justice and HIV, and a PEPFAR consultation. PEPFAR has announced new efforts to build partnerships with faith-based organizations through a global capacity building coordinator.
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1. Faith-based organizations like churches own and operate 30-70% of health care facilities in Africa and play a key role in health care delivery, especially in remote areas. However, they are often not integrated into national health systems.
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This document discusses innovative models for community healthcare financing in Zimbabwe. It outlines the successes and challenges experienced by faith-based organizations in financing healthcare. It describes Zimbabwe's struggling economy and national health financing systems, which rely heavily on taxes, donor funds, and user fees. Faith-based organizations have found successes in obtaining government grants and performance-based financing. However, they face challenges due to poverty, low health financing, and weak health systems. The presentation proposes innovative methods for faith-based groups to improve healthcare financing, such as medical aid insurance, subsidies, decentralized financing, and harnessing the informal sector for additional revenue.
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Lesotho Decentralization experience by Lebohang Mothae, CHALe
- 1. Decentralization/ devolution of healthcare: successes and challenges Presented by Ms Lebohang Mothae Christian Health Association of Lesotho (CHAL)
- 2. Lesotho is a mountainous country completely surrounded by the Republic of South Africa. The country covers a total surface area of about 30,335 Km2, 25% of which is lowlands, and 75% highland. It’s a high altitude country, with the lowest elevation being 1388m above sea level. Lesotho had a population of 2,051,545 people, 52.% of whom are female and 48% male. 77.4% of the population lives in rural areas and only 22.6% is categorised as urban.
- 3. CHAL Hospitals and HCs per district ADMINISTRATIVE ARRANGEMENTS OF LESOTHO 3 levels of government Central level District level (10 Administrative districts) Local level with local councils namely: ◦ 10 District Councils ◦ 1 Municipal Council, ◦ 11 Urban Councils and ◦ 64 Community Councils
- 4. Started in the early years of 2000 Clear Systems and structures put in place in 2007 upon partnership with GoL and the then health sector reforms ◦ Basic Service package, equipment and essential medicines list, financial management system, staffing pattern etc Main functions of facilities decentralized ◦ Governance and leadership, financial and human resources management Typology of facilities determined with clear ToRs Hospitals Categorized as tertiary, district, primary and local hospitals Referral centers from health centers The hospitals have hospital boards as the governing body and the hospital management team that comprises of heads of department assisted by the sub committees such as quality assurance and infection control committees.
- 5. Health centers (Independent and dependant HCs) Lower level of care Primary heath care services Referral from the community The CHAL health Centers have Health Centre Committees (representative of local stakeholders) as governing bodies The Nurse-in-charge has the main responsibility of daily and general management of the health centre CHAL independent HCs are supervised by the District Health Management Team (DHMT) Communities Community Health Workers Support and interest groups Local and international NGOs
- 6. Nature Functions Composition Executive management Team/ Nurse-in- Charge Management team and operational Committees Quality assurance committees Disease control committees Development and implementation of facility operational plans Service quality management Ensure health education and promotion People management Financial and procurement management Mentoring of nurses/ staff
- 7. Nature Functions Boards/ HC Committees Representative of the local stakeholders 5 – 10 members Facility Manager, Medical and nursing professionals, councillor, MoH Rep, Chief, Development partners, business community Ultimate decision making body Strategic leadership Oversight Policy development
- 8. Local decisions for local problems Access and utilization of healthcare services increased Direct linkages with the communities and interest groups – community participation enhanced Ownership and support of facilities by local communities - Commitment and dedication improved Service quality improved
- 9. Resistance to absolute devolution of powers to the local structures/ authorities ◦ Revenue generation sources centralized ◦ Implementation of plans done from central level High levels of poverty and unemployment – income and other resources base limited Lack of capacity and no clear terms of reference for local authorities – source of conflict
- 10. Lack of competencies in areas of management and governance Lack of coordination at District and local levels– results in under utilization of available local resources and poor supervision of facilities Limited resource base (free healthcare service delivery and/or standardized user fees) Standardized staffing pattern not responsive to facility service needs/ demands Abuse of power and authority – mismanagement and misappropriation of resources
- 11. To strengthen the participation of all the key role-players within the catchment area of the facility Build capacity of both management and governing structures – Management and leadership development program Foster collaborations and partnerships with local stakeholders (business community) Improved commitment and support from member church leadership. Advocate for more resources – HRH and finances